- Allied Solutions (Plano, TX)
- …all established recovery and claim service standards and benchmarks for a Claims Investigator . + Promptly and effectively respond to both carrier and lender ... is responsible for the initial setup and investigation of claims prior to the assignment of the claim...This position will also review database information found in systems such as Unitrac, insurance company websites, Lexis Nexis,… more
- Allied Universal (Charleston, WV)
- …for most full-time compliance and investigation jobs! Allied Universal(R) is hiring a Claims Investigator . Claim Investigators validate the facts of loss ... for Insurance claims through scene Investigations, claimant and witness Interviews, document...Fraud Investigator (CFE) + Certified Insurance Fraud Investigator (CIFI) + Fraud Claim Law Associate… more
- Allied Universal (Crossville, TN)
- …compliance and investigation jobs! Allied Universal(R) is hiring a SIU / Claims Investigator . Special Investigations Unit (SIU) Specialists investigate claims ... policies and the components of fraud to determine If claims warrant reporting to the appropriate state agency for...Fraud Investigator (CFE) + Certified Insurance Fraud Investigator (CIFI) + Fraud Claim Law Associate… more
- City of Norfolk, Virginia (Norfolk, VA)
- Paralegal Claims Investigator Print (https://www.governmentjobs.com/careers/norfolk/jobs/newprint/4519534) Apply Paralegal Claims Investigator Salary ... City and related entities, and their employees. The Paralegal Claims Investigator 's role involves assistance in pre-litigation...after to a position with City of Norfolk Retirement System benefits, you will be required to contribute five… more
- CDPHP (Albany, NY)
- …and invites you to be a part of that experience. The SIU Special Investigator will be responsible for investigating complex insurance cases to detect internal and ... external fraud and abuse. The Special Investigator will research and document cases utilizing resources available...investigation. They will assist in performing audits of providers' claim submissions to assure that services rendered and billed… more
- Commonwealth Care Alliance (Boston, MA)
- …CCA departments related to review processes and results. Sr Associate, FWA Investigator Coder utilizes claim analysis, document review, coding knowledge and ... to identify trends related to potentially inappropriate submission of claims by providers and collaborates with other team members...system enhancements, and prepay edits. The FWA Sr. Investigator Coder will be proficient at each step of… more
- New York State Civil Service (Albany, NY)
- … 1 (Korean Language), License Investigator 1 (Spanish Language), Compensation Claims Investigator 1, or Rent Administration Investigator 1.Only the ... Language), License Investigator 1 (Spanish Language), Compensation Claims Investigator 1, or Rent Administration ...may include serving a role within the Incident Command System to support the department's response to regional and… more
- Elevance Health (Columbus, OH)
- …data mining, entity review, law enforcement referral, and use of proprietary data and claim systems for review of facility, professional and pharmacy claims . ... **Senior Investigator ( Investigator Sr)** _Location: This position...to recover corporate and client funds paid on fraudulent claims . **How you will make an impact:** + … more
- State of Colorado (Denver, CO)
- Labor Law - Compliance Investigator II Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4496216) Apply Labor Law - Compliance Investigator ... thorough as possible in documenting your education and work history in the application system . Attachments will not be accepted or considered during any phase of the… more
- Elevance Health (Norfolk, VA)
- …data mining, entity review, law enforcement referral, and use of proprietary data and claim systems for review of facility, professional and pharmacy claims . ... ** Investigator Sr** **Schedule:** 1-2 days per week in...to recover corporate and client funds paid on fraudulent claims . Candidate will need a strong Medicare/Medicaid background with… more
- Molina Healthcare (Omaha, NE)
- **JOB DESCRIPTION** **Job Summary** The Special Investigation Unit (SIU) Investigator is responsible for supporting the prevention, detection, investigation, ... review audits that may also include coding and billing reviews. The SIU Investigator is responsible for reviewing and analyzing information to draw conclusions on… more
- Allied Universal (Coventry, RI)
- …Compliance and Investigations, North America's leading expert insurance claim investigations, compliance and corporate governance company, provides rewarding ... and investigation jobs! Allied Universal(R) is hiring a Surveillance Investigator . Surveillance Investigators perform discreet mobile and stationary surveillance of… more
- State of Maine, Bureau of Human Resources (Augusta, ME)
- Maine Human Rights Investigator - Repost Augusta, ME 04330 | Legal | Full-time Apply by: May 23, 2024 Apply with Linkedin Apply Opening Date: May 9, 2024 Closing ... determine if there are sufficient facts to state a claim . + Develops an appropriate investigative case plan to...with parties and attorneys representing the parties. + Writes Investigator 's Reports applying the appropriate law (Maine Human Rights… more
- Elevance Health (Columbus, OH)
- …data mining, entity review, law enforcement referral, and use of proprietary data and claim systems for review of facility, professional and pharmacy claims . ... ** Investigator ll** **Location** : This position will work...to recover corporate and client funds paid on fraudulent claims . **How you will make an impact:** + … more
- Elevance Health (Columbus, OH)
- …data mining, entity review, law enforcement referral, and use of proprietary data and claim systems for review of facility, professional and pharmacy claims . ... Job Description ** Investigator II** Schedule: 1-2 days per week in...to recover corporate and client funds paid on fraudulent claims . **How you will make an impact:** + … more
- Elevance Health (Indianapolis, IN)
- …data mining, entity review, law enforcement referral, and use of proprietary data and claim systems for review of facility, professional and pharmacy claims . ... ** Investigator II** **Supporting the Payment Integrity line of...to recover corporate and client funds paid on fraudulent claims . **How you will make an impact:** + … more
- EFI Global (Edina, MN)
- …manner; documents all relevant facts pertaining to files in the appropriate claims handling system (s) and keeps management informed of developments that ... requirements for consideration.** **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** **Investigates assigned claims suspected of insurance fraud, this includes large loss,… more
- State of Massachusetts (MA)
- …Unemployment Assistance related to fraudulent activities by reviewing and investigating UI claim data and UI system transactions using pattern recognition ... data patterns and documents pertinent information concerning any potentially fraudulently claim activities or other alleged violations of laws, rules, and… more
- System One (Baltimore, MD)
- …Baltimore, MD (Hybrid) twice a week Job Duties: + Research provider/subscriber claims activity, operations manuals, data systems , medical policies, job duties ... ALTA IT is hiring an Associate Investigator to support a leading health insurance customer....if an individual has committed fraud for the investigators. System One, and its subsidiaries including Joule, ALTA IT… more
- State of Nevada (NV)
- COMPLIANCE/AUDIT INVESTIGATOR 3 APPROXIMATE ANNUAL SALARY - $58,025.52 to $86,150.88 PAY GRADE: 35 For more information on benefit and retirement programs, please ... provide work direction and training to others. The incumbent is a Compliance/Audit Investigator III in the Insurer/TPA Compliance Unit and serves as the lead worker… more